What you need to know about

J-1 Intern Health Insurance
Compliance

The Law

According to immigration regulations (22 CFR S62.14), J-1 Exchange Visitors and accompanying J-2 dependents are required to maintain comprehensive medical insurance with evacuation and repatriation coverage that meets US government minimum requirements beginning on the start date of the J-1 program (indicated in item 3 of the DS-2019) continuing to the end of the J-1 program

Note: CCIP requires "entry to exit" coverage.

There cannot be any breaks or lapses in insurance coverage even if one travels outside the US for an extended period of time during the J program.

The willful failure to carry the required insurance for yourself and, if applicable, your dependents, or material misrepresentation of insurance coverage will result in the termination of your J program and legal status in the US.

Minimum requirements

Maintaining insurance is critical to each exchange visitor's ability to stay in visa status.

A Minimum coverage requirements

#

Item

Minimum Requirements

1

Medical benefits

USD 100,000

2

Repatriation of remains

USD 25,000

3

Medical evacuation

USD 50,000

4

Deductible per accident or illness

USD 500

B Underwriting corporation requirements

1 May require a waiting period for pre-existing conditions that is reasonable as determined by current industry standards;
2 May include provisions for co-insurance under the terms of which the exchange visitor may be required to pay up to 25% of the covered benefits per accident or illness; and
3 Must not unreasonably exclude coverage for perils inherent to the activities of the exchange program in which the exchange visitor participates.

C Underwriting corporation requirements

An A.M. Best rating of "A-" or above; or
1 A McGraw Hill Financial/Standard & Poor Claims-paying Ability rating of "A-" or above; or
2 A Weiss Research, Inc. rating of "B+” or above; or
3 A Fitch Ratings, Inc. rating of "A-" or above; or
4 A Moody’s Investor Services rating of "A3" or above; or
5 Be backed by the full faith and credit of the exchange visitor’s home country; or
6 Part of a health benefits program offered on a group basis to employees or enrolled students by a designated sponsor; or
7 Offered through or underwritten by a federally qualified Health Maintenance Organization or eligible Competitive Medial Plan as determined by the Centers of Medicare and Medicaid Services of the U.S. Department of Health and Human Services.

Coverage period

Your insurance coverage start date must fall on or before your US arrival and your coverage end date must be on or after the date when you leave the US.

If your purchase your own insurance, a copy of your airline-issued itinerary is required for validation.

Individual insurance

Warning!

- Write down the item number next to each item
- Indicate the exchange rate and USD next to each non-US currency item
- Write down the explanation, if needed, next to items 5, 6, and 7

You may purchase your own insurance policy that meets the necessary criteria by submitting qualified proof by the specified deadline. If you fail to do so, you will automatically be enrolled and billed for the group insurance.

Proof of qualified health insurance can be the certificate of coverage or insurance officially issued by your insurance provider. Your proof must show that your insurance meets every single item of the requirements. For any item that you can't locate a relevant clause, supplement the certificate with a letter of explanation issued by your insurance provider.

Qualified proof

#

Item

Description

1

Name of the insurance provider or corporation

2

Participant's name

3

Geographic coverage

Ensure that it shows within the US territories

4

Coverage period

Program period (earlier) and flight itinerary (later)

5A

Medical benefits

Minimum USD 100K

5B

Repatriation of remains

Minimum USD 25K

5C

Medical evacuation

Minimum USD 50K

5D

Deductible per accident or illness

Minimum USD 500K

6A

Covers pre-existing conditions after a reasonable waiting period

6B

Includes a provision for co-payment that does not exceed 25% co-pay by the EV

6C

Does not exclude benefits for perils inherent to the activities of the EV's program

7A

With reference to the subject above (underwriting corporation requirements)

Group insurance

We offer a group health insurance policy to participants through Tokio Marin HCC that meets the federal requirements.

Application is not required for the group insurance enrollment. The initial fee based on your program period is due in the second installment. Later, when your actual "entry-to-exit" period has been determined, any additional fees, if required, will be due upon arrival.

Our group insurance policy is not applicable to those whose visas are not sponsored by us, and US citizens and US green card holders. In such a case, you must purchase your own insurance policy.

The insurance fee is refundable if an email notification is received 7 days prior to the effective day.

Reminder!

Group Insurance

Group insurance

#

Item

Description

1

Plan name

Atlas MultiTrip plan

2

Insurance Provider

MIS Group, a member of Tokio Marine HCC

3

Type

Group policy

4

Maximum coverage

USD 500,000

5

Deductible

USD 100

6

Daily premium (

USD 2.26 (aged 18 to 29)

7

Brcohure 1

https://www.hccmis.com/downloads/ag_brochure.pdf

8

Brcohure 2

https://www.hccmis.com/downloads/ag_brochure.pdf

Affordable Care Act

J-1s and any J-2 accompanying spouse and dependent(s) may be subject to the requirements of the Affordable Care Act [22 CFR 62.14(a)]. Be aware that the ACA requirements may exceed the US Department of State requirements.

Details regarding the ACA can be found at
http://www.hhs.gov/healthcare/rights/index.html, and penalties for lack of coverage can be found at https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/.

Who is subject to ACA?
The answer depends whether an individual is considered a non-resident or resident for tax purposes.
Non-residents for tax purposes are not subject to ACA, whereas residents for tax purposes are subject to ACA.

How do I know whether or not I am a resident or non-resident for tax purposes?
- An individual’s tax residency status is determined by the IRS (Internal Revenue Service)
- Detailed information on determining tax residency status can also be found here:
http://www.irs.gov/publications/p519/ch01.html

Health insurance compliance

Quick facts

Qualified insurance gives you access to better and more timely health care, and provides the only protection against the enormous costs of health care in the US. As a CCIP participant, you are required have medical insurance that meets the minimum J-1 requirements.

Affordable Care Act

Health insurance proof

Submission timeline

If purchasing individual insurance, notify us within 7 days upon admission. Submit qualified proof of coverage (aligned with the program period) within 7 days of Form DS-7002 issuance (N/A to US citizens and LPRs). At least 21 days before departure to the US, submit another proof with coverage period aligned with your flight ticket itinerary.

Admission

If purchasing individual insurance, notify us within 7 days upon admission

Before visa interview

Students who purchase their own insurance must submit qualified proof with coverage aligned with the program period within 7 days upon issuance of Form DS-7002 (US citizens and LPRs please skip)

During visa interview

Bring along insurance proof to your interview; students participating in the group policy will be provided with a letter

Prior to arrival

Knowledge

Health insurance 101

Coinsurance

After you have paid the deductible, the insurance company usually only pays a percentage of your medical expenses. For example, the policy pays 80%, and you pay the remaining 20% of the expense. This is called the coinsurance. The J regulations require the that insurance companies must pay at least 75% of covered medical expenses.

Insurance Exclusions

Most insurance policies do not cover certain conditions. The J regulations require that if a particular activity is a part of your Exchange Visitor program, your insurance must cover injuries resulting from your participation in that activity. Read the list of exclusions carefully so that you understand exactly what is not covered by the policy.

Medical claims

In some cases, the insurance company pays the hospital or doctor directly; in others the company reimburses the policy holder after he or she has paid the bills.

Insurance Identification Card

Once you purchase insurance, the company will provide you with an insurance identification card for use as proof of your coverage when you are seeking health care from a hospital or doctor. Carry it with you at all times when you are in the US.

Generic and Over-The-Counter (OTC) Medications

Generic drugs are generally cheaper and equivalent to the corresponding brand names. If saving money is most important to you, ask the doctor to prescribe generic drugs. OTC medications can be bought by anyone at a pharmacy without a doctor's prescription. These include basic pain-killers and allergy treatments. Prescription drugs are more powerful and are designed to combat infectious illnesses. These require a doctor's authorization before they are dispensed at a pharmacy.

Network and Out-of-Network Doctors

Know the difference between network doctors and non-network doctors; sometimes insurance will not cover visits to doctors who are "out-of-network."

Major Illnesses and Per Occurrence Maximums

Exchange Visitors must have insurance that will pay at least $100,000 for each specific illness or injury (at least a $100,000 per-occurrence maximum). Be aware that medical treatment in the US for major illnesses can significantly exceed that amount.

Pre-certification for medical conditions

Pre-certification is necessary in certain medical situations. If you are unsure whether or not an item is covered or if the condition is severe enough for a hospital visit, the best practice is to call and confirm what can be covered (and obtain a pre-certification number, if available).

Prescription Medication

Unlike in Asia, where doctors typically dispense medicine themselves, the American system involves pharmacies that distribute the proper medications. At the end of your doctor visit, the doctor will send a prescription to the pharmacy, which you will then retrieve and pay for yourself, separate from the doctor's expense.

Primary Care Physician (PCP), Specialists, and Referrals

PCP refers to your primary health doctor. For specific health issues and injuries, you may need to visit a specialist. Referrals may be required for specialist visits in order for the claims to be covered.

Health Care Premium

Health insurance companies typically charge fees on a monthly basis. The fee is called the premium. It is combined with the premiums of others to form a pool of money. That money is then used to pay the medical bills of those participants who need health care.

Health Insurance Deductables

It covers your medical bills after a certain amount is met. Your portion is called the deductible, before the company pays anything. Under the J regulations, the deductible cannot exceed $500 per accident or illness.

Got questions?

We've got answers!

Students can easily get sick for various reasons, for example, a change in weather or an unhealthy lifestyle. There are many doctors around our residence. For minor medical issues, see a family doctor. In some cases, your family doctor may refer you to a specialist. Depending on the severity of your sickness, you may also visit an urgent care clinic (a few of them are located along Northern Blvd) or visit a hospital.

Unlike in Asia, where doctors typically dispense medicine themselves, the American system involves pharmacies that distribute the proper medications. At the end of your doctor visit, the doctor will send a prescription to the pharmacy, which you will then retrieve and pay for yourself, separately from the doctor's expense.

There are many pharmacies located within walking distance of our residence. You are free to use the pharmacy of your choice. Regardless of which pharmacy you choose, ensure that your write down the address of the pharmacy ahead of time and give it to the doctor for electronic prescription transmission

Prescription is not covered in many insurance plans. As such, you may consider signing up for the Rite Aid Rx Savings Program, which allows you to save 15% or more on many both brand name and generic prescription drugs.

Yes. Students are obligated to read the manuals and handle claims on their own. Regarding health insurance, our services are limited to group insurance purchasing, giving regulation related advices, and providing necessary resources. Our policy refrains us from referring you to specific doctors. However, we are more than happy to provide assistance within our service parameters.

About CCIP

The Cross Cultural Internship Program (CCIP) is an Exchange Visitor Program (J-1 Intern) that takes place every summer from May through August.